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The thesis contains a summary of issues relating the quality and safety of services and healthcare environment. The theoretical part is a cross section of the whole topic of quality and safety from a culture of quality and safety, ensuring and creating safe care at European and global level, through causes and prevention of adverse events, the influence of the European Union on this issue, the national legislation, the accreditation investigation and evaluation of the quality and safety. The research is focused towards deeper investigation the issue, clarification of concepts, causes and contexts. The pur-pose is not to draw conclusions directly, but to explore how some facilities are in comparison with the theory and in comparison with each other. The purpose and goal of this work is to determine whether the currently implemented measures and changes lead to improving of services and greater safety. The main goal of the thesis is: To determine whether the introduction of DSO (Departmental security objectives) has a positive effect on patient safety in health facilities in Pilsen and South Bohemia regions and compare the differences. As a tool to clarify the quality and safety I chose a descriptive qualitative research and quantitative analysis of adverse events in observed group. Quality was assessed by using questionnaire consisting of the main and most important parts of the theoretical concept. From data obtained by questionnaire was subsequently compiled a description of the culture of quality and safety of each facility and then compared. A numeric data was used to compare the incidence of adverse events before and after the implementation of a program of continuous improving quality and safety as well as between members of the research group.

Given the credence nature of food quality and food safety attributes, consumers cannot easily verify whether food is high quality or is safe to eat, thus they rely on abstract systems of regulation and quality signals such as brands to make informed consumption choices. In fact, trust is recognized as a rational strategy that reduces consumers’ uncertainty when purchasing goods with credence attributes. While trust in food is a topical issue in an era of increasingly complex food systems, how trust and more precisely brand trust affects consumers’ perceptions of food is a relatively new research area in food economics. This thesis aims to answer questions such as what drives trust in the actors within the Canadian food system (i.e. government, farmers, food manufacturers, and food retailers) and in food brands, and the relationship between that trust and consumer confidence in food quality and food safety. Previous studies on institutional and system trust have been carried out primarily in the sociology, marketing and political sciences disciplines, while a few studies in food economics have investigated the influence of institutional trust and reported the degree of public trust in market actors. This study extends previous research on consumer trust in the context of food by developing a conceptual model in which trust in the food system and brand trust are expected to evolve to public confidence in credence attributes and lead to consumer commitment to food brands. Inspired from a comprehensive synthesis of the literature on consumer trust, the theoretical background suggests that consumer confidence in food attributes is jointly determined by trust in the food system (system-based trust) and brand trust (product-based trust), and it is moderated by consumer characteristics (personal-based trust) – namely: risk, past consumption experience and ethically-motivated behaviour. As well, consumers are assumed to perceive an actor or a brand as trustworthy through the influence of four postulated dimensions of trust: perceived competence, credibility, benevolence and reputation. A Structural Equation Modelling (SEM) approach is used for the empirical analysis. Data were gathered through an online survey of consumers conducted across Canada in July 2012 focusing on fresh chicken and packaged green salad products. The results show that individually none of the postulated antecedents of trust (i.e. competence, credibility, benevolence and reputation) was a significant driver for trust, especially for packaged salad. Unlike previous research on institutional trust and brand trust that uses a number of separate dimensions to measure trust predominantly in non-food contexts, this thesis finds that trust in the food system and food products could be measured differently by taking into account the interactive effects of perceived competence, credibility, reputation and benevolence on public trust. As such, the findings suggest that Canadian consumers tend to trust brands of chicken and packaged salad when these products are perceived as high quality, are backed by credible information, have a good reputation and, at the same time, enhance consumers’ welfare. In fact, a brand cannot be perceived as high quality and safe to eat (brand competence) without containing transparent information signalling its quality and safety (brand credibility). Additionally, results reveal some apparent product-specific effects: brand trust matters in fostering consumer confidence in chicken but not for salad. Furthermore, trust in the food system as a whole appears to be more influential in leading to public confidence in credence attributes than trust in food brands in the case of chicken. As such, it appears that trust in actors within the food supply chain is more important than relying on individual products. As well, the analysis shows that while psychographic variables (risk aversion, past consumption experience) and some demographics (e.g. gender, education) moderate the relationship between trust in the food system and brands for chicken, this is not the case for salad. In terms of marketing implications, the results suggest that while brands are useful signalling mechanisms, trust in these brands is not the main driver for consumer confidence in credence attributes. Furthermore, the much stronger effect of system trust implies that decision-makers would benefit by investing in building trust relationships with the public. Transparent communication and credible assurances about the practices and the intentions within the food system could be a way to gain and maintain public trust and, ultimately, consumer confidence in food quality and food safety.

Yes / Objective: To assess developments over time in the capture, curation and use of quality and safety information in managing hospital services. Setting: Four acute National Health Service hospitals in England. Participants: 111.5 hours of observation of hospital board and directorate meetings, and 72 hours of ward observations. 86 interviews with board level and middle managers and with ward managers and staff. Results: There were substantial improvements in the quantity and quality of data produced for boards and middle managers between 2013 and 2016, starting from a low base. All four hospitals deployed data warehouses, repositories where datasets from otherwise disparate departmental systems could be managed. Three of them deployed real-time ward management systems, which were used extensively by nurses and other staff. Conclusions: The findings, particularly relating to the deployment of real-time ward management systems, are a corrective to the many negative accounts of information technology implementations. The hospital information infrastructures were elements in a wider move, away from a reliance on individual professionals exercising judgements and towards team-based and data-driven approaches to the active management of risks. They were not, though, using their fine-grained data to develop ultrasafe working practices. / NIHR Health Service and Delivery Research (HS&DR) programme, project 13/07/68.

Yes / Background: There have been concerns about the quality and safety of NHS hospital services since the turn of the millennium. This study investigated the progress that acute NHS hospital trusts have made in developing and using technology infrastructures to enable them to monitor quality and safety following the publication in 2013 of the second Francis report on the scandal at Mid Staffordshire NHS Foundation Trust (The Mid Staffordshire NHS Foundation Trust Public Inquiry. Chaired by Sir Robert Francis QC. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. HC 898. London: The Stationery Office; 2013). Methods: A telephone survey of 15 acute NHS trusts in the Yorkshire and the Humber region, and a review of board papers of all acute NHS trusts in England for January 2015, were undertaken. The telephone survey was used to identify trusts for a larger field study, which was undertaken in four acute NHS trusts between April 2015 and September 2016. The methods included the direct observation of the use of whiteboards and other technologies on two wards in each trust, an observation of board quality committees, semistructured interviews and an analysis of the quality and safety data in board papers. Published sources about national and local agencies were reviewed to identify the trust quality and safety data that these agencies accessed and used. An interview programme was also undertaken with those organisations. The Biography of Artefacts approach was used to analyse the data. Findings: The data and technology infrastructures within trusts had developed over many years. The overall design had been substantially determined by national agencies, and was geared to data processing: capturing and validating data for submission to national agencies. Trust boards had taken advantage of these data and used them to provide assurance about quality and safety. Less positively, the infrastructures were fragmented, with different technologies used to handle different quality and safety data. Real-time management systems on wards, including electronic whiteboards and mobile devices, were used and valued by nurses and other staff. The systems support the proactive management of clinical risks. These developments have occurred within a broad context, with trusts focusing on improving the quality and safety of services and publishing far more data on their performance than they did just 3 years earlier. Trust-level data suggest that quality and safety improved at all four trusts between 2013 and 2016. Our findings indicate that the technology infrastructures contributed to these improvements. There remains considerable scope to rationalise those infrastructures. / National Institute for Health Research Health Services and Delivery Research programme.

The call to better prepare nurses in safety and quality performance resulted from the concern of the Institute of Medicine regarding egregious gaps and errors in U.S. hospitals that resulted in serious injuries and patient deaths. Quality and safety education for nursing (QSEN) competencies were set forth in 2005 to enhance nursing curricula and nursing students' preparation for practice; however, QSEN's integration and implementation have been gradual and inconsistent. This qualitative interpretive study was guided by Senge's principles of the learning organization and Benner's professional development model. Using face-to-face interviews, the perspectives of 9 full-time nursing faculty members at 2 private nursing colleges in the Northeast United States were obtained about QSEN integration into their curriculum. Data analysis employed the use of open in vivo coding, categorizing, and the formation of themes. The results indicated that QSEN integration was perceived as complex and daunting due to faculty's limited knowledge about QSEN, lack of adequate preparation to develop and employ instructional strategies, lack of adequate time to teach, and limited learning opportunities at clinical sites to develop competencies such as teamwork and collaboration and informatics. Meaningful reform in nursing education may occur as leaders engage faculty members in meaningful dialogue to better understand the complexity and challenges of QSEN integration, including faculty members' needs for successful implementation. Nursing students may then be better trained to understand the nature and consequences of human and system errors and appreciate higher standards of care that will result in a decrease in preventable injuries, medication errors, and patient deaths.

The aim of this thesis is to find out the financial gain of the integrated system of management quality, human safety and environment by the valuation of the company. My thesis includes the evaluation of the efficiency of integrated system of management quality, human safety and environment and after that there is included the valuation of the company in two versions. The first version reflects the real situation, the company has implemented the integrated system of management quality, human safety and environment. The second version reflects the hypothetical situation, in this settings the company wouldn't have the integrated system. The difference between these two valuation is the financial gain of this system.

The aim of this study was to determine the quality of slaughtered ostrich meat and to evaluate the ostrich slaughter process, to determine whether ostrich meat are contaminated by the in-house slaughtering practices and if prevalence of microorganisms increase with the succession of the slaughter process. Furthermore, the presence of specific foodborne pathogens and spoilage organisms was explored by means of molecular and conventional methods to determine whether ostrich meat is a source of these microorganisms. Data obtained from this study provides some baseline information that could be used in future studies on system contamination and the extent of downstream processing steps in the production of ostrich meat. Antimicrobial resistance has become a growing area of concern in both human and veterinary medicine, it is therefore necessary that another aim of this study was to determine the antibiotic resistant pattern of Staphylococcus aureus in ostrich meat in order to establish whether Staphylococcus aureus strains isolated from ostrich meat samples show resistance to antibiotics

The aim of this study was to determine the quality of slaughtered ostrich meat and to evaluate the ostrich slaughter process, to determine whether ostrich meat are contaminated by the in-house slaughtering practices and if prevalence of microorganisms increase with the succession of the slaughter process. Furthermore, the presence of specific foodborne pathogens and spoilage organisms was explored by means of molecular and conventional methods to determine whether ostrich meat is a source of these microorganisms. Data obtained from this study provides some baseline information that could be used in future studies on system contamination and the extent of downstream processing steps in the production of ostrich meat. Antimicrobial resistance has become a growing area of concern in both human and veterinary medicine, it is therefore necessary that another aim of this study was to determine the antibiotic resistant pattern of Staphylococcus aureus in ostrich meat in order to establish whether Staphylococcus aureus strains isolated from ostrich meat samples show resistance to antibiotics

Magister Scientiae - MSc / The aim of this study was to determine the quality of slaughtered ostrich meat and to evaluate the ostrich slaughter process, to determine whether ostrich meat are contaminated by the in-house slaughtering practices and if prevalence of microorganisms increase with the succession of the slaughter process. Furthermore, the presence of specific foodborne pathogens and spoilage organisms was explored by means of molecular and conventional methods to determine whether ostrich meat is a source of these microorganisms. Data obtained from this study provides some baseline information that could be used in future studies on system contamination and the extent of downstream processing steps in the production of ostrich meat. Antimicrobial resistance has become a growing area of concern in both human and veterinary medicine, it is therefore necessary that another aim of this study was to determine the antibiotic resistant pattern of Staphylococcus aureus in ostrich meat in order to establish whether Staphylococcus aureus strains isolated from ostrich meat samples show resistance to antibiotics. / South Africa